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Your Child

Concussions May Have Long Term Impact on Kids’ Mental Health

1:45

There’s been a tremendous amount of information about concussions in the news lately. One question many parents want answered is, if my child suffers a concussion could it have an impact on his or her mental, physical or intellectual health for the rest of their lives?

The answer is yes according to a recent study, and for kids who have had more than one concussion; the risks are even higher that they will suffer repercussions into adulthood.

A report released by the health insurer, Blue Cross Blue Shield, said diagnosed concussions among people under the age of 20 climbed 71 percent between 2010 and 2015. Part of that increase may be attributed to an improved awareness of the dangers of concussions, prompting coaches and parents to seek medical attention for athletes and kids.  However, the high numbers also suggest that more children are experiencing head injuries than in the past.

The data also showed that twice as many boys were diagnosed with concussion than girls, although the rates for girls increased by 119 percent during the dates examined.

While more general information about concussion is becoming abundant, the effects on the health of children into adulthood have largely remained unknown.

For the new study looking into the long-term effects, multiple data sources were reviewed including a valuable collection of records from Sweden.

A plethora of linked registries in that nation contain information about people’s medical and hospital visits, socioeconomic status, education, physical disabilities and other aspects of their lives, says Dr. Seena Fazel, a professor of forensic psychiatry at Oxford and the new study’s senior author. The registries also allow researchers to compile information about family members.

In this case, the scientists concentrated on all Swedes born between 1973 and 1985 and looked for those who had experienced a head injury of some kind before the age of 25. More than 104,000 people qualified. Researched reviewed data about these people for 40 years.

Along with each patient, researchers also compiled similar medical records for a sibling who had not been diagnosed with a head injury and compared the results between family members and the total population of the country.

The results of the study were unsettling. They found that young people who had experienced a single diagnosed concussion were more likely to be receiving medical disability payments as adults, to have at some point sought mental health care, were less likely to have graduated from high school or attended college and were twice as prone to die prematurely than their uninjured sibling.

If the patient had experienced more than one concussion while young or if the brain injury was more severe than a concussion, the possibility of physical and psychological problems during adulthood increased.

While the results of the study were disconcerting, there was also good news in the report. Not everyone who had a concussion or brain injury as a child or teenager experienced mental or intellectual problems -related to the brain injury - as an adult.

“The majority of individuals who had diagnoses of brain injury in our study did not experience adverse outcomes,” Dr. Fazel says.

Unfortunately, it is impossible at the moment to identify which children or teenagers who experience head trauma may be most at risk of struggling in later life and which will instead recover without apparent complications, he says.

The overall message from this study is that all steps should be taken to prevent childhood head injuries.

If a young person does suffer head trauma, he continues, more and longer-lasting monitoring is also probably a good idea. Such monitoring may be especially important if the child shows any signs of “a decline in psychosocial performance,” Dr. Fazel says, such as a drop in grades or a change, even subtle, in personality. A neurologist can provide useful assessments, and regular follow-up neurological assessments may need to be continued, even into adulthood.

The study was published online in the journal PLOS Medicine.

 Story source: Gretchen Reynolds, http://www.nytimes.com/2016/10/05/well/move/a-single-concussion-may-have-lasting-impact.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl

Parenting

Day Care Doesn’t Boost Weight Gain in Kids

1:45

With three out of five American children in some type of daycare arrangement, parents are often concerned about whether their child is eating a healthy diet when they can’t supervise what they are being served.

Previous studies have suggested that kids in daycare were more likely to gain excess weight, but a new study says other factors linked to obesity were not considered in earlier research.

"When we implemented these more sophisticated analytical approaches, we found that association really went away," said study author Dr. Inyang Isong, an instructor at Harvard Medical School and a pediatrician with Boston Children's Hospital.

"We cannot say that sending a child to day care makes your child overweight ," Isong continued. "We just don't have enough evidence to say that."

Given that so many children are in daycare, the updated analysis is good news for parents.

 Pediatricians and parents have had longstanding concerns that childcare might increase a young one’s risk of gaining weight, said Dr. Allison Driansky, an attending pediatrician at Cohen Children's Medical Center in New Hyde Park, N.Y.

Most states do not have strict regulations regarding diet and exercise provided at day care, Isong and Driansky said.

"The concern was anytime you take control out of a parent's hands about what a child is eating or what a child is doing during a day, that could lead to obesity," Driansky said. "Not every parent is lucky enough to have a top-of-the-line day care. I think there was some concern that the day care wouldn't cooperate with what a parent wants for their child."

The new study included data from about 10, 700 U.S. children from diverse social, economic and ethnic backgrounds.

Factors such as the child’s gender, race, age and weight of the mother, family economic and social status, how many parents lived at home and the quality of the neighborhood were included in the analysis.

While the results pointed to no association between daycare and weight gain, Isong noted that this study "is not in any way full proof." Such proof would involve a clinical trial in which children would be randomly assigned to either childcare or home care.

The study did however offer a more detailed look at daycare and weight gain.

"We tried to control for a vast array of factors that could influence decisions to place children in child care," Isong said. "When we controlled for all those factors, the association went away."

Parents have the final say in what their children eat and do when they are not in daycare. Parents can encourage their little ones to be active, play outdoors and when old enough, find a sport they enjoy. Sugary drinks (including juices) should be limited and plenty of fruits and vegetables encouraged. Many experts recommend that children not watch TV before the age of two and that it be limited to 1 hour a day after that.

The study was published online in the October edition of the journal Pediatrics.

Story source: Dennis Thompson, http://www.webmd.com/children/news/20161010/day-care-doesnt-encourage-weight-gain-in-kids#2

Parenting

Helping Kids Cope With Tragic Events

2:00

Another all too common tragedy has saddened the hearts of Americans this week. Just 35 days after a man opened fire on a crowd of concertgoers in Las Vegas, killing 58 people and wounding nearly 500 others, another mass killing has taken place. This time in the small community of Sutherland Springs, Texas, leaving 26 people dead and 10 critically injured.  About half of the victims were children, according to news reports. This follows a terrorist attack in New York City on Halloween that killed 8 people. The heartbreak and numbers are gut wrenching to think about.

These kinds of horrific events can make the world seem like a terrifying place, particularly for kids.

How can you help your child cope with such frightening news? As a parent or a caregiver, how you react can have a strong impact on how your child views his or her own safety.

Dr. Jennifer Caudle, an associate professor at Rowan University School of Osteopathic Medicine in Stratford, suggests that parents shield their children from news reports.

"Children may become upset by news coverage," Caudle said. So monitor and limit what they see, hear or read. This may reduce their anxiety and help them deal with these unsettling events, she explained.

Other suggestions include:

  • Ask your child what they have already heard about the event. 
  • Provide the facts but try not to make judgments about the situation. 
  • Avoid upsetting details, and reassure children that people are working hard to make things better for everyone. 
  • Don't pressure kids to talk about the events, but encourage them to share their feelings by talking, drawing or writing. 
  • Let children know they can come to you for information and that they are free to ask questions. 
  • Remind children that their home is a safe place. 
  • Let children know that people may react differently to hard-to-understand events.

If your child or adolescent seems to be obsessing over the events and is having a hard time putting things in perspective, they may need professional help. 

"Problems with sleeping, changes in appetite or behavior, mood changes and new physical complaints, such as stomach aches and headaches, could -- in some children -- be a sign that they are having a difficult time coping," she said. "If this is the case, make sure your child sees a health care professional."

The National Institute of Mental Health (NIMH) says that it is important to let your child know that you will do your best to take care of him or her, that you love them and it’s okay for them to feel upset or sad.

NIMH also offers these tips:

  • If your child is having trouble sleeping give them extra attention, let them sleep with a light on, or let them sleep in your room (for a short time).
  • Try to keep normal routines, for example, reading bedtime stories, eating dinner together, watching TV together, reading books, exercising, or playing games.

Unfortunately, these types of tragedies don’t appear to being going away anytime soon. But, you can help your child (and yourself) by reminding them that although there are some people that might want to inflict harm on others, most people are loving and kind. They want a safe place for children to grow up in and they are doing their best to make this world a better place.

Story sources: Mary Elizabeth Dallas, https://consumer.healthday.com/mental-health-information-25/child-psychology-news-125/helping-children-cope-when-a-mass-tragedy-strikes-728263.html

https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-violence-and-disasters-parents/index.shtml

Your Child

Why Kids Should Learn Handwriting

1:45

I think it’s fair to say that handwriting is becoming a lost art. Computers, tablets and phone keyboards have made actual writing with a pen and paper almost obsolete.

What was once an integral part of a child’s daily school lessons, today, gets about one-fourth the instruction time. What is surprising is that in the not too far future, some kids may never learn penmanship at all.

If keyboards become the most popular form of communication, is there really a need for printing and cursive skills? Yes, according to some educators. Not only will children lose the personal touch of handwriting but will they also lose the benefits learning penmanship offers the developing brain.

Putting pen to paper stimulates brain circuits involved with memory, attention, motor skills, and language in a way punching a keyboard doesn't.

"There is this assumption that we live in the computer age, and we don't need handwriting anymore. That's wrong," says Virginia Berninger, PhD, a professor of educational psychology at the University of Washington.

Indiana University psychologist Karin James, PhD, recently published a study looking at brain scans of preschoolers before and after they learned to produce letters, either by printing or typing. Before the lesson, the children couldn't decipher between a random shape and a letter, and their brains responded similarly to each. After they learned to hand-draw a letter, brain regions needed for reading lit up at the sight of the letter like they do in a literate adult. Learning to type a letter yielded no such change.

Other studies have shown that preschoolers that practice handwriting read better in elementary school.

Handwriting also requires concentration and teaches brain circuits responsible for motor coordination, vision, and memory to work together. "If in the future we were to take away teaching handwriting altogether, I worry there could be real negative impacts on children's development," James says.

Timed right, cursive also comes with some unique advantages. Berninger's research suggests kids who link their letters via cursive get a better handle on what those words look like and end up being better spellers, she says. Cursive also allows them to compose their thoughts faster than in block handwriting or via typing (at least until about seventh grade, when their brains become mature enough to manage two-handed typing quickly).

Berninger says parents can offer their children extra guidance with learning handwriting even before their child begins school and through their early years. Some children may learn these skills quicker and some may need a little more practice. But on an average:

Preschoolers can strengthen motor skills by playing with clay, stringing beads, working through mazes, and connecting dots with arrows to form letters.

From kindergarten through second grade, children should master block letters.

Third to fourth grade is when kids can begin and master cursive.

By fifth grade, children should continue to write by hand while being introduced to typing by touch (not just hunt and peck.)

As I’ve become more accustomed to using my computer or phone to communicate with others, I’ve noticed that my own handwriting skills are beginning to suffer. Cursive isn’t as fluid and readable as when I handwrote more often and my eye, hand and pen coordination isn’t near as comfortable as it used to be. 

I hope future generations will not lose the art of handwriting, not only because of the developmental benefits it offers, but because each person’s handwriting is unique to them.

Story source: Lisa Marshall, http://www.webmd.com/parenting/features/handwriting-matters-kids#1

Your Child

Skin Cancer Risk Higher for Redheaded and Fair Skin Children

1:45

Too much exposure to sunlight can damage the skin, particularly for children who have pale skin, red or fair hair, freckles or the type of skin that sunburns easily. 

Researchers found that having the genes that give you red hair, pale skin and freckles increases your risk of developing skin cancer as much as an extra 21 years of sun exposure.

Their study found gene variants that produce red hair and freckly, fair skin were linked to a higher number of mutations that lead to skin cancers. The researchers said even people with one copy of the crucial MC1R gene - who may be fair-skinned but not have red hair - have a higher risk.

"It has been known for a while that a person with red hair has an increased likelihood of developing skin cancer, but this is the first time that the gene has been proven to be associated with skin cancers with more mutations," said David Adams, who co-led the study at Britain's Wellcome Trust Sanger Institute.

"Unexpectedly, we also showed that people with only a single copy of the gene variant still have a much higher number of tumor mutations than the rest of the population."

Redheads have two copies of a variant of the MC1R gene which affects the type of melanin pigment they produce, leading to red hair, freckles, pale skin and a strong tendency to burn in the sun.

Exposure to ultraviolet light from either the sun or sunbeds causes damage to DNA and scientists think the type of skin pigment linked to redheads may allow more UV to reach the DNA.

In this latest study, the researchers found that while this may be one factor in the damage, there are also others linked to the crucial MC1R gene.

Although skin cancer is rare in children, the amount of sun exposure during childhood is thought to increase the risk of developing skin cancer in adult life. Children who have had episodes of sunburn are more likely to develop skin cancers in later life.

The skin of children is more delicate and more prone to damage. Therefore, take extra care with children, and keep babies out of the sun completely.

Because infants’ skin is so sensitive, it’s better in the first six months to shield them from the sun rather than use sunscreen. It’s especially important to avoid direct sun exposure and seek the shade during the sun’s hours of greatest intensity, between 10 AM and 4 PM. Keep to the shady side of the street on walks, and use the sun shield on your stroller

Once your baby reaches 6 months of age, it’s time to introduce sunscreens. Choose a broad-spectrum, water-resistant sunscreen that offers a minimum sun protection factor (SPF) of 15. Look at the active ingredients; zinc oxide and titanium dioxide are good choices, because these physical filters don’t rely on absorption of chemicals and are less apt to cause a skin reaction. Test your baby’s sensitivity to the sunscreen first, by applying a small amount on the inside of baby’s wrist.

Toddlers should also be kept in the shade between 10 AM-4 PM. Protect young children with sunscreen, hats, sunglasses and lightweight clothing that covers the skin.

The study was published in the journal Nature Communications.

Most kids get much of their lifetime sun exposure before age 18, so it's important for parents to teach them how to enjoy fun in the sun safely. Taking the right precautions can greatly reduce your child's chance of developing skin cancer.

Story sources: http://patient.info/health/preventing-skin-cancer

http://www.foxnews.com/health/2016/07/12/skin-cancer-risk-for-freckly-red-heads-equivalent-to-21-years-in-sun.html

http://www.skincancer.org/prevention/sun-protection/children/oh-baby

 

 

Your Child

Young Girls Less Likely to See Women as “Really, Really Smart”

2:00

One of the surprise box office hits this year is “Hidden Figures.” It’s based on the true story of a team of female African-American mathematicians at NASA in the late 50s and early 60s that helped launch the first U.S. astronaut into space. The women were brilliant but faced enormous challenges for acceptance because of their race and gender.

According to a new study, you might could say that there are millions of "hidden figures" in who young girls and boys’ perceive as someone who is “really, really smart.”

Researchers wanted to try and figure out why women are underrepresented in the science, technology, engineering and mathematics, or STEM, fields. While most women make the decision to pursue these courses in high school or college, the scientists found that children develop a stereotype of which gender is naturally smarter early in life.

The study involved 400 children, aged 5 to 7 and included a story told by Lin Bian, a co-author and psychologist at the University of Illinois.

“There are lots of people at the place where I work, but there is one person who is really special. This person is really, really smart,” said Bian. “This person figures out how to do things quickly and comes up with answers much faster and better than anyone else. This person is really, really smart.”

She then showed them pictures of four adults—two men and two women—and asked them to guess which was the protagonist of the story. She also gave them two further tests: one in which they had to guess which adult in a pair was “really, really smart”, and another where they had to match attributes like “smart” or “nice” to pictures of unfamiliar men and women.

The results were revealing.  The 5 year-old boys and girls associated the “smart” person with their own gender. But among those aged 6 or 7, only the boys still held to that view. At an age when girls tend to outperform boys at school, and when children in general show large positive biases towards their own in-groups, the girls became less likely than boys to attribute brilliance to their own gender.

As the boys continued to believe in their own intelligence, the girls – on average – tended to see everyone on more equal terms.

Bian also found that the older girls were less interested in games that were meant for “really, really smart” children.

The stereotype that brilliance and genius are male traits is common among adults. In various surveys, men rate their intelligence more favorably than women, and in a recent study of biology undergraduates, men overrated the abilities of male students above equally talented and outspoken women.

Bian’s study suggests that the seeds of this bias are planted at a very early age. Even by the age of 6, boys and girls are already diverging in who they think is smart.

The findings could help illuminate the challenge schools face in combating gender stereotypes, even though girls often outperform boys in school. Girls drop out of high school at a lower rate than boys. Women are more likely than men to enroll in college, and they earn more college degrees each year than men.

Other games were played and social tests were given during the study with similar results. The 5 year-olds were equally interested in participating, but the 6 and 7 year-old girls were less interested in the ones that relied on “being smart.” Both genders were attracted to the games requiring persistence and hard work.

In today’s business and scientific world, more educators, policymakers and corporations are making an effort to include women in leadership roles, but breaking through the stereotypes developed at such a young age can hinder girls and women in those and other disciplines.

Children model what they see. If they are raised in an environment that diminishes young girls’ achievements but rewards young boys for the same achievements, it often sets up a life-long struggle for them to feel and accept their own self-value. 

Teachers also play an important role in encouraging all children to reach their highest achievement level.

Young girls, as well as young boys, should be recognized for their intelligence and encouraged to pursue science, technology, engineering and math studies – the rest of the world will benefit.

The research can't explain how these messages are getting to kids or how they could be changed, says Andrei Cimpian, a professor of psychology at New York University and an author of the study, He is planning a long-term study of young children that would measure environmental factors, including media exposure and parental beliefs. That would give a better idea of what factors predict the emergence of stereotypes, and what levers are available to change attitudes.

The study was published in the journal Science.

Story sources:  Ed Yong, https://www.theatlantic.com/science/archive/2017/01/six-year-old-girls-already-have-gendered-beliefs-about-intelligence/514340/

Katherine Hobson, http://www.npr.org/sections/health-shots/2017/01/26/511801423/young-girls-are-less-apt-to-think-women-are-really-really-smart

Nick Anderson, https://www.washingtonpost.com/news/grade-point/wp/2017/01/26/research-shows-young-girls-are-less-likely-to-think-of-women-as-really-really-smart/?utm_term=.fc30e9030500&wpisrc=nl_sb_smartbrief

 

Your Child

Obesity Related Heart Disease Found in Children as Young as 8

2:00

All you have to do is look around, wherever children are gathered, to see that there are far too many kids that are overweight in this country.  And sadly, some of these children may already be developing heart disease according to a new study.

The study reports that obese children as young as 8 years of age, are beginning to show signs of heart abnormalities.

"It is both surprising and alarming to us that even the youngest obese children in our study who were 8 years old had evidence of heart disease," said study lead author Linyuan Jing, a postdoctoral fellow with Geisinger Health System in Danville, Pa.

"Ultimately, we hope that the effects we see in the hearts of these children are reversible," Jing added. "However, it is possible that there could be permanent damage."

Researchers conducted MRI scans of 40 children between 8 and 16 years old. Half of the participants were obese; the other half was of normal weight for their age and height.

They found that the obese children had an average of 27 percent more muscle mass in the left ventricle region their heart, and 12 percent thicker heart muscle overall. Both are considered indicators of heart disease, Jing said.

Among 40 percent of the obese children, scans showed thickened heart muscle had already translated into a reduced ability to pump blood. The children with this reduced heart capacity were considered to be at “high risk” for adult cardiac strain and heart disease.

"This should be further motivation for parents to help children lead a healthy lifestyle," Jing said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, called the findings "alarming."

Some of the obese children in the study were struggling with health complications often associated with excess weight, including asthma, high blood pressure and depression, the researchers said. But none displayed customary warning signs of heart disease such as fatigue, dizziness or shortness of breath, Jing said.

The study did not include kids with diabetes or those that were too large to fit inside the MRI scanning machine. Jing noted that the study might actually underestimate how many children are suffering from heart related problems associated with obesity.

Jing said it’s up to parents to help their children maintain a healthy weight. They should buy healthy foods instead of cheap fast food and fruit juice, "which is high in sugar but low in fiber," she said.

She also recommended that parents limit TV, computer and video game time and encourage more physical outdoor activities.

Childhood obesity isn’t just an American problem; it’s a global problem as well.  The World Heart Federation says that one in 10 school-aged children worldwide are estimated to be overweight. However, in the USA, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980.

The researchers believe that schools can play a role in helping families understand the health problems associated with obesity.

“…Schools and communities need to do a better job at educating both the parents and children about the health risks of overweight and obesity," said Jing.

Fonarow agreed adding, "Substantially increased efforts are needed to prevent and treat childhood obesity."

The findings were presented at the annual meeting of the American Heart Association in Orlando, Fla.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Source: Alan Mozes, http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/obese-kids-as-young-as-8-show-heart-disease-signs-705099.html

 

 

 

Daily Dose

Should Children Lift Weights?

I am often asked by both young patients and their parents if children can participate in weight lifting and strengthening exercises.

I think the appropriate term is strength training and conditioning, rather than weight lifting, which connotes competition and the need for heavier and heavier weights. When done appropriately, strength training and conditioning is great for kids of all ages, and really encourages being physically fit. Weightlifting is not appropriate for a growing child as it can put too much strain on the tendons and cartilage. This is especially true when kids become competitive about lifting bigger and bigger weights at the risk of long-term injury. Allowing children to weight lift in hopes of “bulking up” or “building the biggest muscles” before pubertal development and their growth spurt is inappropriate. All of that can be deferred for the post pubertal athlete. On the other hand, an age appropriate strength training and conditioning program may actually be protective of a child’s joints by increasing their muscle strength and their endurance. By participating in supervised and structured strengthening programs, a child as young as eight may improve their endurance, body awareness and balance, all of which are beneficial. A strength-training program can be done without weights, as in resistance training, by simply using the child’s body weight. Examples of this would be abdominal crunches, push-ups and pull-ups. These are great ideas for the younger children. For older children free weights or resistance bands may be added. Parents or coaches who are familiar with the use of free weights should always supervise. Start out with lighter weights, and make sure that the child can do at least 10 repetitions with the weight, if not, drop to a lower free weight. Have the adult watch the child for form and technique and supervise any increase in weights or repetitions. There are also many programs through local gyms and YMCA’s tailored just for kids to participate in strength training. When beginning a conditioning program encourage your child to have a warm up period, with a little aerobic activity like walking or running as this his will help to warm the muscles and prevent injury. After the strength training it is equally important to have a cool down period with gentle stretching. Many children enjoy working out with their parents and this can become a family activity (we can all use the exercise) to promote coordination, healthy bones, joints, cholesterol and blood pressure. Most importantly make it fun! That’s your daily dose, we’ll chat again tomorrow.

Parenting

Hobby Lobby Recalls 43,000 Light-Up Spinner Toys

1:00

Hobby Lobby is recalling about 43,000 children’s battery-powered, light-up spinner toys sold in two themes: Easter and July 4th. The Easter-themed toys were sold in blue with a pink bunny on the dome and yellow with a yellow and orange chicken on the dome. The July 4th spinners are red with white stars painted on the blue dome. “Hobby Lobby” and item number 9130033 or 9130082 is printed on the spinner handle. Three LR44 coin cell batteries power the spinners.

The battery cover can detach and expose the small coin cell batteries, posing choking and ingestion hazards to young children.

Hobby Lobby has received one report of a 14-month-old child who ingested the battery.

Consumers should immediately take the recalled spinners away from children and return them to the nearest Hobby Lobby or Mardel store. Consumers with a receipt will receive a full refund and consumers without a receipt will receive a store credit.

The spinners were sold at Hobby Lobby and Mardel stores nationwide from February 2017 to April 2017 for about $5.

Consumers can contact Hobby Lobby Stores at 800-326-7931 between 9 a.m. and 6 p.m. ET Monday through Friday, or online at www.hobbylobby.com and click on the Recall tab for more information.

Story source: https://www.cpsc.gov/Recalls/2017/Hobby-Lobby-Recalls-Easter-and-July-4th-Light-Up-Spinner-Toys

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DR SUE'S DAILY DOSE

What every parent needs to know about teen suicide.

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